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Is Vivitrol the same as Suboxone?

Medically reviewed by Sally Chao, MD. Last updated on May 27, 2021.

Official answer

by Drugs.com

Vivitrol is not the same as Suboxone, but both drugs are used to treat opioid use disorder.

  • Vivitrol contains the drug naltrexone alone, and is administered monthly through an injection.
  • Suboxone is a combination of naloxone and buprenorphine, and the medicine is taken orally on a daily basis.

Vivitrol and Suboxone both contain opioid antagonists, naltrexone and naloxone, respectively. Opioid antagonists are drugs that bind to opioid receptors in your brain and block them from allowing opioids, such as heroin or prescription pain opioids, to bind and deliver a “high.”

The naltrexone in Vivitrol is a maintenance therapy that blocks the effects of opioids. On the other hand, the naloxone in Suboxone, which is taken orally, will only be activated as a blocker if the medicine is abused and injected. The naloxone in Suboxone is there to deter patients from injecting the drug to heighten its effects, as it will block these effects and initiate withdrawal symptoms if injected.

Along with the antagonist naloxone, Suboxone’s active drug is buprenorphine, a drug that is similar to other opioids, but produces more mild effects.

Both medicines can help prevent relapse and reduce opioid cravings, but Vivitrol does not mimic the effects of opioids, while the buprenorphine in Suboxone produces mild, opioid-like effects.

If Vivitrol is injected before opioid detoxification is complete, the naltrexone will bind to the brain’s opioid receptors, knocking out any remaining opioids, and potentially triggering a sudden onset of intense withdrawal symptoms called precipitated withdrawal. Before starting Vivitrol, patients will need to be opioid-free for at least 7 to 14 days, depending on the type of opioid used.

Suboxone can also cause precipitated withdrawal when taken too early, but patients typically only have to wait between 12 to 24 hours after last opioid use.

Unlike Suboxone, Vivitrol is also indicated for the treatment of alcohol dependence.

References
  1. Food and Drug Administration (FDA). Vivitrol (naltrexone for extended-release injectable suspension). October 2010. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021897s015lbl.pdf. [Accessed April 16, 2021].
  2. Food and Drug Administration (FDA). Suboxone (buprenorphine and naloxone) sublingual tablets. February 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020733s028lbl.pdf. [Accessed April 16, 2021].
  3. American Society of Addiction Medicine (ASAM). National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. 2020. Available at: https://www.asam.org/docs/default-source/quality-science/npg-jam-supplement.pdf?sfvrsn=a00a52c2_2. [Accessed April 16, 2021].
  4. Substance Abuse and Mental Health Services Administration (SAMHSA). Buprenorphine. March 12, 2021. Available at: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. [Accessed April 16, 2021].
  5. Substance Abuse and Mental Health Services Administration (SAMHSA). Naltrexone. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone. [Accessed April 20, 2021].
  6. National Alliance on Mental Illness (NAMI). Buprenorphine/Naloxone (Suboxone). January 2021. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Buprenorphine/Buprenorphine-Naloxone-(Suboxone). [Accessed April 19, 2021].

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